Oral Antibiotic
Antibiotics are effective for inflammatory acne because of their antibiotic activity and anti-inflammatory effects (54). It is recommended to use oral antibiotics as second-line therapy for short-term management and as an adjunctive treatment when hormonal therapies alone are inadequate (42). Tetracyclines, mainly doxycycline and minocycline, are the most commonly prescribed agents (55). Macrolides such as azithromycin are commonly used when tetracyclines are not tolerated or contraindicated (56). Monotherapy with oral antibiotics should be avoided to reduce the development of antibiotic-resistant Propionibacterium acnes (P acne), and limit the treatment to 3-6 months (57). Trimethoprim/sulfamethoxazole, penicillins, and cephalosporins have evidence support their efficacy to use for acne (44, 58).